Attention Deficit/Hyperactivity Disorder in Individuals with Non-Syndromic Craniosynostosis: A Systematic Review and Meta-Analysis

Figures & data

Figure 1. Flowchart of study selection process.

Table 1. Summary demographic characteristics of participants (17 independent studies) at baseline.

	Ncraniosynostosis studies	Ncraniosynostosis participants	Mean (SD)	Ncontrol studies	Ncontrol participants	Mean (SD)
Sample size	17	2389	141 (278) Median = 65	6	12742	2124 (5025) Median = 47
Age (years)	16	1151	7.3 (3.5)	5	362	7.7 (4.1)
			%			%
Age group
preschool (≥2 to <5 yrs)	5	611	25.6	1	221	1.7
primary school (≥5 to <12 yrs)	10	475	19.9	3	111	0.9
secondary school (≥12 yrs)	1	65	2.7	1	30	0.2
not reported	1	1238	51.8	1	12380	97.2
Sex
male	14	1508	63.1	4	8821	69.2
female	14	655	27.4	4	3874	30.4
not reported	3	226	9.5	2	47	0.4
Suture location^a
sagittal	9	441	18.5	-	-	-
metopic	11	527	22.1	-	-	-
unicoronal	4	136	5.7	-	-	-
lambdoid	2	13	0.5	-	-	-
not reported	2	1272	53.2	-	-	-
Surgical status^a
post-surgery	10	1999	83.7	-	-	-
conservatively managed	3	180	7.5	-	-	-
combined	3	176	7.4	-	-	-
not reported	1	34	1.4	-	-	-
Recruitment source
hospital/craniofacial unit	15	1095	45.8	-	-	-
national population registry	1	1238	51.8	-	-	-
social media	1	56	2.3	-	-	-
Control group
yes	6	1650	69.1	-	-	-
no	11	739	30.9	-	-	-
Type of control group
siblings	1	30	1.8	-	-	-
community	5	1620	98.2	-	-	-
Study origin
Europe	9	1821	76.2	-	-	-
US	6	474	19.8	-	-	-
Australia	2	94	3.9	-	-	-
Socioeconomic status
reported	7	509	21.3	-	-	-
not reported	10	1880	78.7	-	-	-
Family history of ADHD reported
yes	0	0	0	-	-	-
not reported	17	2389	100.0	-	-	-
Family history of craniosynostosis
yes	2	94	3.9	-	-	-
not reported	15	2295	96.1	-	-	-

Note: N_studies and N_participants refers to the number of independent studies and participants for which there were available data.

^asome studies reported data for multiple subgroups.

Figure 2. Prevalence rates, odds ratios and standardized mean differences of ADHD diagnoses or symptoms associated with ADHD, in children with craniosynostosis, partitioned according to suture type, surgical status and age.

Note: c/s = craniosynostosis; in the subgroup analyses, some studies contribute data to more than one category

Figure 3. Prevalence rates, odds ratios and standardized mean differences of attention problems or attention functioning, in children with craniosynostosis, partitioned according to type of measure administered.

Note: c/s = craniosynostosis; in the subgroup analyses, some studies contribute data to more than one category

Figure 4. Standardized mean group differences and prevalence rates for levels of hyperactivity symptoms in children with craniosynostosis.

Note: c/s = craniosynostosis

Data availability statement

The authors confirm that the data supporting the findings of this meta-analysis are available within its supplementary materials